Senior Credentialing Specialist

The Senior Credentialing Specialist provides operational leadership, coordination, and governance oversight for the Medical Staff Services department. This role directs all phases of practitioner credentialing, initial appointment, recredentialing, and clinical privileging for physicians and Advanced Practice Providers (APPs) in compliance with The Joint Commission (TJC), CMS Conditions of Participation, state and federal regulations, and Medical Staff Bylaws. Additionally, this position facilitates Medical Staff governance, supports committee functions (MEC, Credentials, Peer Review), coordinates FPPE/OPPE workflows, maintains continuous regulatory readiness, and provides leadership and peer guidance to department personnel.

Education & Experience

• Associate degree in Healthcare Administration, Business, Health Information Management, or related field required; Bachelor’s degree strongly preferred. Equivalent direct experience in medical staff services may be considered in lieu of degree.
• Minimum of 3–5 years of progressive experience in medical staff credentialing, privileging, and medical staff governance within an acute-care hospital setting. Experience leading or guiding team members is preferred.

Technical & Interpersonal Skills

• In-depth knowledge of The Joint Commission (TJC) standards, CMS Conditions of Participation, state medical board regulations, and NPDB reporting requirements.
• Advanced proficiency in credentialing software systems, enterprise document management platforms, and Microsoft Office 365 (Word, Excel, PowerPoint, Teams, Outlook).
• Superior written and oral communication skills; demonstrated ability to draft clear governance minutes, formal committee resolutions, and executive correspondence.
• Proven ability to handle delicate, highly confidential provider matters and peer review investigations with sound judgment and objectivity.